Abstract: An examples of a system for delivering neurostimulation to a patient may include a stimulation output circuit configured to deliver the neurostimulation, a sensing circuit configured to sense a neural signal indicative of neural responses to the neurostimulation, and stimulation control circuit. The stimulation control circuit may be configured to control the delivery of the neurostimulation using a plurality of stimulation parameters and may be configured to detect morphological features of the neural responses, to produce a neural response parameter using the detected morphological features, to detect a change in the sensed neural signal, to analyze the produced neural response parameter for attributing the detected change to one of a neural activation change in the patient or a body movement of the patient, and to control a dynamically controlled stimulation parameter of the plurality of stimulation parameters using the sensed neural signal and an outcome of the analysis.

Abstract: A neuromodulation system for use with electrodes to modulate a volume of neural tissue may include a waveform generator and a controller. The waveform generator may be configured to be electrically connected to the electrodes and provide an electrical waveform through at least some of the electrodes to provide a neuromodulation therapy. The controller may be configured to use a program to control the waveform generator to deliver a neuromodulation therapy by delivering both a fast-acting sub-perception neuromodulation and a slow-acting sub-perception neuromodulation. The fast-acting neuromodulation has a wash-in transition period less than a first time duration, and the slow-acting sub-perception neuromodulation has a wash-in transition period more than a second time duration, the second time duration being longer than the first time duration.

Abstract: A system for percutaneous photobiomodulation (PBM) that can deliver light that is configured outside the body directly to target tissue is described. The system can be used to treat both chronic and temporary conditions with PBM. The system includes a light source and a controller that includes a memory storing a predefined dosing requirement and a processor to access the memory and signal the light source to generate a light signal for PBM of a target area within a patients body based on the predefined dosing requirement. In some instances, the system also includes a port to deliver the light signal received from the light source to the target area. The light source and the port can be connected by an attachment that can transmit the light signal from the light source to the port.

Abstract: A method of treating a patient and an external programmer for use with a neurostimulator. Electrical stimulation energy is conveyed into tissue of the patient via a specified combination of a plurality of electrodes, thereby creating one or more clinical effects. An influence of the specified electrode combination on the clinical effect(s) is determined. An anatomical region of interest is displayed in registration with a graphical representation of the plurality of electrodes. The displayed anatomical region of interest is modified based on the determined influence of the specified electrode combination on the clinical effect(s).

Abstract: Methods for determining stimulation for a patient having a stimulator device are disclosed. A model is received at an external system indicative of a range or volume of preferred stimulation parameters, which model is preferably specific to and determined for the patient. The external system receives a plurality of pieces of fitting information for the patient, including information indicative of a symptom of the patient, information indicative of stimulation provided by the stimulator device during a fitting procedure, and/or phenotype information for the patient. The external system determines one or more sets of stimulation parameters for the patient using the pieces of fitting information. In one example, training data is applied to the pieces of fitting information to select the one or more sets of stimulation parameters from the range or volume of preferred stimulation parameters in the model.

Abstract: Methods, apparatuses and systems for ophthalmic therapy. Electrical therapy delivery characteristics are determined using a testing or calibration phase and a patient's known disease state. Expected values for phosphene thresholds in the patient's eye are used along with measurements characterizing a relationship between therapy output from electrodes near the eye to the energy that is actually received at the eye, such as by corneal measurements. The result may include a determination of therapy delivery targets and/or an estimate of the patient's disease state.

Abstract: Methods and systems can facilitate identifying effective electrodes and other stimulation parameters, as well as determining whether to use cathodic and anodic stimulation. Alternately, the methods and systems may identify effective electrodes and other stimulation parameters based on preferential stimulation of different types of neural elements. These methods and systems can further facilitate programming an electrical stimulation system for stimulating patient tissue.

Abstract: Methods and systems for testing and treating spinal cord stimulation (SCS) patients are disclosed. Patients are eventually treated with sub-perception (paresthesia free) therapy. However, supra-perception stimulation is used during “sweet spot searching” during which active electrodes are selected for the patient. This allows sweet spot searching to occur much more quickly and without the need to wash in the various electrode combinations that are tried. After selecting electrodes using supra-perception therapy, therapy is titrated to sub-perception levels using the selected electrodes. Such sub-perception therapy has been investigated using pulses at or below 10 kHz, and it has been determined that a statistically significant correlation exists between pulse width (PW) and frequency (F) in this frequency range at which SCS patients experience significant reduction in symptoms such as back pain.

Abstract: A system and method for selecting leadwire stimulation parameters includes a processor iteratively performing, for each of a plurality of values for a particular stimulation parameter, each value corresponding to a respective current field: (a) shifting the current field longitudinally and/or rotationally to a respective plurality of locations about the leadwire; and (b) for each of the respective plurality of locations, obtaining clinical effect information regarding a respective stimulation of the patient tissue produced by the respective current field at the respective location; and displaying a graph plotting the clinical effect information against values for the particular stimulation parameter and locations about the leadwire, and/or based on the obtained clinical effect information, identifying an optimal combination of a selected value for the particular stimulation parameter and selected location about the leadwire at which to perform a stimulation using the selected value.

Abstract: Software for providing a Graphical User Interface (GUI) for use in a clinician programmer for programming an implantable pulse generator (IPG) or external trial stimulator (ETS) is disclosed. A user may define in the GUI multiple pole configurations (e.g., monopoles, bipoles, etc.) which may be used independently to provide stimulation to a patient via the IPG or ETS's electrode array. Selected of the pole configurations can be linked or associated as a group in the GUI and used to concurrently provide stimulation. The pole configuration group may be steered or moved in the electrode array using a single movement instruction which moves all pole configurations in the group simultaneously. This allows the relative positions of the pole configurations in the group to remain constant as the group is moved.

Abstract: A computer implemented system and method provides a volume of activation (VOA) estimation model that receives as input two or more electric field values of a same or different data type at respective two or more positions of a neural element and determines based on such input an activation status of the neural element. A computer implemented system and method provides a machine learning system that automatically generates a computationally inexpensive VOA estimation model based on output of a computationally expensive system.

Abstract: A system may include at least one medical device and a processing system. The medical device may be configured to treat a condition by delivering a therapy to a patient. The therapy is at least partially defined using a parameter set. The processing system may be configured for use to acquire clinical effect data (CED) for the condition, acquire a medication state of medication administered to treat the condition, adjust the CED based on the medication state to provide medication-adjusted CED, and identify an adjusted parameter set for the at least one medical device to deliver the therapy based on the medication-adjusted CED. The adjusted parameter set may be communicated to a clinician (or patient or other user) as a suggestion or may be automatically implemented to update the therapy.

Abstract: An example of a system may include electrodes on at least one lead configured to be operationally positioned for use in modulating a volume of neural tissue, where the neural tissue has an activation function. The system may further include a neural modulation generator configured to deliver energy using at least some electrodes to generate a modulation field within the volume of neural tissue. The neural modulation generator may be configured to use a programmed modulation parameter set to generate the modulation field. The programmed modulation parameter set having values selected to control energy delivery using the at least some electrodes to achieve an objective function specific to the activation function of the volume of neural tissue to promote uniformity of a response to the modulation field in the volume of neural tissue along a span of the at least one lead.

Abstract: A system for subcutaneous photobiomodulation (PBM) is described. The system includes a light source that can generate light inside the body (subcutaneously) and a light transmission medium and an emitter that can deliver the light directly to a target location within tissue of the body to treat one or more medical conditions. For example, the light signal can be used to treat a medical condition, which can be controlled/regulated by at least one small nerve and the light signal can be configured for delivery to the at least one small nerve.

Abstract: A neuromodulation system for use with electrodes to modulate a volume of neural tissue may include a waveform generator and a controller. The waveform generator may be configured to be electrically connected to the electrodes and provide an electrical waveform through at least some of the electrodes to provide a neuromodulation therapy. The controller may be configured to use a program to control the waveform generator to deliver a neuromodulation therapy by delivering both a fast-acting sub-perception neuromodulation and a slow-acting sub-perception neuromodulation. The fast-acting neuromodulation has a wash-in transition period less than a first time duration, and the slow-acting sub-perception neuromodulation has a wash-in transition period more than a second time duration, the second time duration being longer than the first time duration.

Abstract: Software for providing a Graphical User Interface (GUI) for use in a clinician programmer for programming an implantable pulse generator (IPG) or external trial stimulator (ETS) is disclosed. A user may define in the GUI multiple pole configurations (e.g., monopoles, bipoles, etc.) which may be used independently to provide stimulation to a patient via the IPG or ETS's electrode array. Selected of the pole configurations can be linked or associated as a group in the GUI and used to concurrently provide stimulation. The pole configuration group may be steered or moved in the electrode array using a single movement instruction which moves all pole configurations in the group simultaneously. This allows the relative positions of the pole configurations in the group to remain constant as the group is moved.

Abstract: Methods and systems for providing stimulation therapy are disclosed. Embodiments of the system include an implantable stimulator and an external controller configured to control the implantable stimulator. A clinician can prescribe a set amount of stimulation therapy to a patient. The external controller is programmed with the prescription. As the patient uses the external controller and the stimulator device the external controller tracks the amount of stimulation the patient uses. Once the patient has used all of the prescribed therapy the patient may return to the clinician for a follow-up appointment.

Abstract: Symptoms of maladies originating in the same region of a brain can be treated with selective multifrequency stimulation. A first stimulation at a first frequency and a second stimulation at a second frequency can be generated by a signal generator. The first stimulation can be applied to a first location in the brain region to trigger an excitation period for a first set of neural elements in the brain region to treat at least one symptom of the malady. The second stimulation can be applied, after a time to ensure the first set of neural elements has entered a refractory period, to a second location in the brain region to trigger an excitation period for a second set of neural elements in the brain region to treat the at least one symptom and/or at least another symptom. The first set of neural elements is not excited by the second stimulation.

Abstract: An improved neural mapping technique can use two stimulations. The first stimulation can be used to excite a first group of neural elements with a first stimulation parameter set. After the first group of neural elements has entered a refractory state, a second group of neural elements can be excited with a second stimulation parameter set. The response to at least the second stimulation parameter set can be measured and at least one property of constituents of the first group of neural elements and at least one property of constituents of the second group of neural elements can be estimated.

Abstract: A method or system for facilitating the determining and setting of stimulation parameters for programming an electrical stimulation system using closed loop programming is provided. For example, pulse generator feedback logic is executed by a processor to interface with control instructions of an implantable pulse generator by incorporating one or more machine learning engines to automatically generate a proposed set of stimulation parameter values that each affect a stimulation aspect of the implantable pulse generator, receive one or more clinical responses and automatically generate a revised set of values taking into account the received clinical responses, and repeating the automated receiving of a clinical response and adjusting the stimulation parameter values taking the clinical response into account, until or unless a stop condition is reach or the a therapeutic response is indicated within a designated tolerance.